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NPI Code Detail

MEDICARE: MS. CAROL ANN STEGALL LCDC II, ICADC,OCPSA

MEDICARE: MS. CAROL ANN STEGALL LCDC II, ICADC,OCPSA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor101175OH

General Provider Information

NPI Number : 1972042125
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CAROL ANN STEGALL LCDC II, ICADC,OCPSA
Provider Business Mailing Address
First Line : 1409 E LIVINGSTON AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43205-2926
Country : US
Telephone Number : 614-253-4448
Fax Number : 614-253-5005
Provider Business Practice Location Address
First Line : 1409 E LIVINGSTON AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43205-2926
Country : US
Telephone Number : 614-253-4448
Fax Number : 614-253-5005
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2017
Last Update Date : 02/21/2017

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Directions to “ MS. CAROL ANN STEGALL LCDC II, ICADC,OCPSA” Practice Location

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